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BACK ON TRACK (APT) PSYCHOLOGICAL THERAPIES REFERRAL FORM Tel: 0300 123 1156 Fax: 0300 123 1158 By Post: 179183 Fulham Palace Road, London W6 8QZWebsite: www.backontrack.nhs.uk Email: haft. Referral@NHS.surname: FIRST

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How to fill out back on track referral

01

Obtain a back on track referral form from the appropriate authority

02

Read and understand the instructions provided on the form

03

Fill in personal details such as name, address, and contact information

04

Provide information about the reason for needing the back on track referral

05

Attach any necessary supporting documents, such as medical records or evidence of hardship

06

Double-check all the entered information to ensure accuracy

07

Submit the completed referral form to the designated office or person

08

Follow up on the status of the referral if necessary

Who needs back on track referral?

01

Individuals who have experienced difficulties or setbacks in their personal or professional lives and require additional support or resources to get back on track.

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What is back on track referral?

Back on track referral is a program that allows individuals to be referred for help with substance abuse issues.

Who is required to file back on track referral?

Healthcare providers, counselors, or other professionals who identify individuals struggling with substance abuse are required to file back on track referral.

How to fill out back on track referral?

Back on track referral can be filled out online or through a paper form provided by the referring agency.

What is the purpose of back on track referral?

The purpose of back on track referral is to help individuals receive the support and resources they need to overcome substance abuse issues.

What information must be reported on back on track referral?

Back on track referral must include the individual's contact information, reason for referral, substance abuse history, and any relevant medical or treatment records.

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